Cook County Health seeks early expansion of Medicaid

Cook County Health seeks early expansion of Medicaid

The Cook County Health and Hospitals System is seeking approval to add thousands of uninsured patients to the Medicaid rolls nearly two years early, a move that could generate millions of dollars in new revenue for the cash-strapped network.

Approval would mean that the public health system would be reimbursed for some of the roughly $550 million of annual free care it now provides. Cook County health system executives decline to say how much revenue they expect to gain. The system treats about 100,000 uninsured patients a year, though that includes people who are ineligible for Medicaid.

The additional revenue could reduce the annual subsidy — $252 million for 2012 — that county taxpayers pay to keep the health system afloat.

Pushing the application through is at the top of the health system’s “life or death” list for financial survival, said Warren Batts, chairman of the independent hospital board that oversees the health system.

The federal health care overhaul calls for a massive enlargement of the Medicaid program in 2014. The expansion is expected to create competition among health care facilities for Medicaid patients, potentially threatening the Cook County health system’s already weakened finances.

The county health system wants the new Medicaid eligibility rules to be applied to its patients later this year instead of waiting until 2014, when federal health care reform begins. Such a move would give the public hospital system a competitive head start on serving the new Medicaid patients.

“When 2014 comes, almost all the people that we would treat would have Medicaid available to them, and unless we perform with a very good patient focus, we’ll end up with a fairly sizable operation with even greater need for a subsidy because we won’t have offsetting revenues coming from regular Medicaid patients,” Mr. Batts said.

The Obama administration already has approved an early start to the new Medicaid rules in four states, according to Menlo Park, Calif.-based Kaiser Family Foundation, which specializes in health care policy.